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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 5/2021

01-05-2021 | Pleural Effusion | Original Article

Talc pleurodesis in malignant pleural effusion: a systematic review and meta-analysis

Authors: Eleftherios T. Beltsios, Georgios Mavrovounis, Antonis Adamou, Nikolaos Panagiotopoulos

Published in: General Thoracic and Cardiovascular Surgery | Issue 5/2021

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Abstract

Objective

Malignant pleural effusion is a severe and common complication in patients with primary or metastatic malignancies of the pleura. Although talc pleurodesis is widely used for managing malignant pleural effusions, there is still controversy in the literature regarding its superiority compared to other approaches. We conducted this meta-analysis to further investigate its efficacy compared to alternative interventions.

Methods

We systematically reviewed the PubMed, Cochrane, and Scopus databases to identify studies that fulfilled our inclusion criteria. Study quality was evaluated using validated tools and the pooled Risk Ratio (RR) and confidence interval (CI) were calculated. We performed sensitivity analyses based on the meta-analysis method and type of study.

Results

Twenty-four studies were included in the current systematic review meta-analysis. Talc pleurodesis was associated with statistically significant higher successful pleurodesis rates when compared with all controls [RR (95% CI) 1.15 (1.00, 1.31); Pz = 0.04], only chemical controls [RR (95% CI) 1.26 (1.13, 1.40); Pz < 0.0001], and bleomycin [RR (95% CI) 1.22 (1.05, 1.42); Pz = 0.008]. The comparison between talc pleurodesis and controls at the > 1-month follow-up time point favored talc pleurodesis [RR (95% CI): 1.62 (1.15, 2.27); Pz = 0.005]. Finally, talc poudrage was associated with a statistically significant higher successful pleurodesis rate when compared with all controls. Sensitivity analyses verified the robustness of our results.

Conclusion

Talc pleurodesis is an effective MPE management approach presenting borderline statistically significant superiority compared to control methods especially compared to bleomycin as well as when pleurodesis success is evaluated later than 1 month postoperatively.
Appendix
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Metadata
Title
Talc pleurodesis in malignant pleural effusion: a systematic review and meta-analysis
Authors
Eleftherios T. Beltsios
Georgios Mavrovounis
Antonis Adamou
Nikolaos Panagiotopoulos
Publication date
01-05-2021
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 5/2021
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-020-01549-2

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